Iatrogenic cholinergic syndrome in the treatment of myasthenia gravis: a case report
Keywords:
Acetylcholine, Atropine, Cholinergics, Myasthenia gravisAbstract
Introduction: cholinergic syndrome encompasses a set of symptoms and signs caused by an excess of acetylcholine or exogenous substances that stimulate the Parasympathetic Nervous System. It may be caused by overdose of cholinergic drugs such as pyridostigmine.
Objective: to present the case of a patient with iatrogenic cholinergic syndrome in the treatment of myasthenia gravis.
Case Presentation: a 22-year-old male patient with a history of myasthenia gravis is presented, who arrived at the emergency room suffering from chest pain predominantly in the left hemithorax, profuse sweating, paleness, coldness, extreme bradycardia and arterial hypotension. After the interrogation, it was learned that he was taking pyridostigmine, an anticholinesterase drug to treat his underlying illness. His doctor had prescribed an increase in the dose because he was decompensated, which probably triggered the cholinergic syndrome.
Conclusions: the case is presented due to the importance of early identification of muscarinic and nicotinic signs and symptoms, added to the need to promptly correct possible complications that could lead the patient to a fatal outcome.
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